Health Care on McCain Horizon

Republican US presidential candidate Senator John McCain leaves a roundtable meeting at Miami's Children Hospital in Florida April 28, 2008. (Reuters)

By Michael D. Shear
TAMPA, Fla. -- In Sen. John McCain's perfect health care world, individuals would each seek the ideal health insurance policy in a competitive marketplace that would drive down premiums even as prevention and healthier living reduces the cost of care.

That's the vision McCain will outline Tuesday morning as he launches a week-long discussion of health care and his efforts to improve quality and increase access. The vision is not new -- he's been talking about it for months -- but aides promised a few more details as McCain seeks an alternative to the plans being offered by Democrats.

The centerpiece of McCain's plan remains a $5,000 tax credit that individuals could use to search out the best insurance for their needs. McCain economic adviser Doug Holtz-Eakin told reporters in a briefing Monday evening that the tax credit would allow some people to leave their employer-sponsored plan and do better on their own.

The plan, he said, "allows those people who are buying on their own to get the same tax benefit" by entering a "big, competitive national market" for health insurance. He said McCain is also backing new public education campaigns to encourage healthier lifestyles and new incentives for the use of medical technology to lower costs.

Critics of the plan lambasted it today as inadequate and said there is little evidence that a open market alone will improve access or lower costs.

"What we are seeing from John McCain is a version of what George Bush has tried to do," said Elizabeth Edwards, wife of former Democratic candidate John Edwards and a fellow at the Center for American Progress. "It's the idea that the market will take care of us."

Edwards disputed that notion, saying that people who are forced into the competitive marketplace today are faced with higher costs for insurance, not lower costs. And she said people who have pre-existing conditions are often met with prohibitively high premiums.

"John McCain's health care program works very well if you happen to be rich and healthy -- and not very well if those are not descriptions of you," she said.

Holtz-Eakin said McCain's plan does not envision a fully-functioning market for insurance right away, but he could not say how long it would take. In the meantime, he said McCain would seek to find "best practices" among state programs that aim to take care of people in the marketplace who have medical conditions that make it very expensive to get insurance.

"You have to phase all these policies in," he said. "I don't think anyone thinks all this happens overnight."